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Reciprocity is a fundamental element in social interactions and implies an adequate response to the previous actions of our interactant. It is thus crucial to detect if a person is cooperating, deceiving, or cheating, to properly respond. However, older adults have been shown to have a lower ability to detect reciprocity compared to younger adults, partially tying this decline to cognitive functions. Another likely association to reciprocity in literature is made with personality dispositions, i.e., agreeableness, altruism, and empathic concern, and Theory of Mind (ToM). Consequently, the present study investigated age-related differences in the detection of the different components of reciprocity, as well as examined the predictors of reciprocity, such as cognitive measures, personality dispositions, and true and false beliefs in young (n = 98; 20–39 years), middle-aged (n = 106; 40–64 years), and older adults (n = 103; 65–96 years). The Mind Picture Story-Theory of Mind Questionnaire was used to measure the reciprocity components and true and false beliefs in each group. This study reported a significant decline in reciprocity detection from adults aged 65 years old and over. Additionally, the ability to detect reciprocity was significantly linked to cognitive functioning and ToM across all age groups, especially in older adults. [ABSTRACT FROM AUTHOR]

Jokes understanding is an important part of people's social life, especially in aging. However, little is known about older adults' humor understanding and the role of the cognitive skills underpinning social communication, mainly pragmatics and theory of mind (ToM). To fill this gap, we created the Phonological and Mental Jokes (PMJ) task, a fine-grained task distinguishing two types of jokes based on the mentalistic load. The PMJ task was administered, together with the Assessment of Pragmatic Abilities and Cognitive Substrates (APACS) test for pragmatics and the Strange Stories for ToM, to 147 older adults (age-range 60–85). Through structural equation modeling (SEM), we analyzed: i) the latent structure of the PMJ task; ii) the relationships between humor comprehension, pragmatics, and ToM, controlling for other background variables (vocabulary, education, and age). Results revealed a two-latent-factor model for the PMJ task, which separated phonological from mental jokes. Furthermore, pragmatic skills predicted humor comprehension irrespective of the type of joke, whereas the relationship between humor understanding and ToM skills was specific, being significant for mental, but not for phonological, jokes. These results suggest that humor understanding is part of the larger pragmatic competence of older adults and that it may additionally tax ToM skills when reasoning about the mental states of the joke's characters is required. These findings pave the way to a lifespan consideration of humor in social communication and add to the debate over the relationship between pragmatics and ToM, showing the different role of these abilities in humor. [ABSTRACT FROM AUTHOR]

To evaluate the subjective experience of the COVID-19 outbreak in healthy older adults and develop a model of the older population's psychological adaptation to the COVID-19 pandemic. A qualitative grounded theory approach was taken to the study design and analysis, using semi-structured interviews to collect data from 19 community-active Italian older people by telephone during the first wave of COVID-19 (May 2020). The theory emerging from the study conceptualized the COVID-19 subjective experience in older people as an adjustment process to the disruption of habits, social contacts, and routines that prompted a meaning-making process to face this adverse experience. Three emergent categories included 'loss, uncertainty, and distress' as the psychological impact of the pandemic emergency, 'making sense of COVID-19' as a subjective sense-making process of the pandemic, and 'living with the pandemic' as agency and self-management within the pandemic experience. The resulting narratives encompassed themes, i.e. risk perception, representation of the self, connection with past-time memories, and compliance with safety measures. The results have implications for designing effective messages to promote hope, social responsibility, and commitment in aging during the COVID-19 pandemic and for health workers who wish to support the psychological health of older adults. [ABSTRACT FROM AUTHOR]

Background: A specific evaluation of the capacity to consent to research in older adults with cognitive decline is often not included routinely in research practice. However, there is a need to evaluate this competence adopting brief standardized instruments to guarantee their ethical rights. The present study evaluated in older adults with normal cognitive functioning, and major and mild neurocognitive disorders whether the Mini-Mental State Examination (MMSE) and a brief battery of neuropsychological tests are sensitive and specific to discriminate subjects able to provide consent to research. Methods: 54 participants with Major Neurocognitive Disorder (MajorNCD), 22 with Mild Neurocognitive Disorder (MildNCD), and 37 Normal Cognitive Functioning individuals (NCF). The capacity to provide consent was assessed using the MacArthur Competence Assessment Tool for Clinical Research. Cognitive functioning was assessed using the MMSE, Verbal Fluency Tests, Trail Making Test (TMT-A), Immediate and Delayed Recall Test. Results: In the MildNCD and NCF groups, the aggregate score of neuropsychological tests showed high sensitivity and specificity in classifying subjects able to provide consent to research. In the MajorNCD group, MMSE, Recall test, and TMT-A performed better than the aggregate score in classifying subjects as able of consenting to the hypothetical research. Conclusion: The choice of the best tool to assess the ability to provide consent to research may depend on the degree of cognitive impairment. MMSE is a good tool for subjects with MajorNCD. A more comprehensive battery of neuropsychological tests would represent a better tool in NCF and MildNCD individuals. [ABSTRACT FROM AUTHOR]

Background prior statin treatment has been shown to have favourable effects on short- and long-term prognosis in patients with acute coronary syndrome (ACS). There are limited data in older patients. The aim of this study was to investigate the association of previous statin therapy and presentation characteristics, infarct size and clinical outcome in older patients, with or without atherosclerotic cardiovascular disease (ASCVD), included in the Elderly-ACS 2 trial. Methods data on statin use pre-admission were available for 1,192 of the 1,443 patients enrolled in the original trial. Of these, 531 (44.5%) were already taking statins. Patients were stratified based on established ASCVD and statin therapy. ACS was classified as non-ST elevation or ST elevation myocardial infarction (STEMI). Infarct size was measured by peak creatine kinase MB (CK-MB). All-cause death in-hospital and within 1 year were the major end points. Results there was a significantly lower frequency of STEMI in statin patients, in both ASCVD and No-ASCVD groups. Peak CK-MB levels were lower in statin users (10 versus 25 ng/ml, P  < 0.0001). There was lower all-cause death in-hospital and within 1 year for subjects with ASCVD already on statins independent of other baseline variables. There were no differences in all-cause death for No-ASCVD patients whether or not on statins. Conclusions statin pretreatment was associated with more favourable ACS presentation and lower myocardial damage in older ACS patients both ASCVD and No-ASCVD. The incidence of all-cause death (in-hospital and within 1 year) was significantly lower in the statin treated ASCVD patients. [ABSTRACT FROM AUTHOR]

Studies on age-related differences in risk perception in a real-world situation, such as the recent COVID-19 outbreak, showed that the risk perception of getting COVID-19 tends to decrease as age increases. This finding raised the question on what factors could explain risk perception in older adults. The present study examined age-related differences in risk perception in the early stages of COVID-19 lockdown, analyzing variables that can explain the differences in perception of risk at different ages. A total of 1,765 adults aged between 18 and 87 years old completed an online survey assessing perceived risk severity and risk vulnerability of getting COVID-19, sociodemographic status, emotional state, experience relating to COVID-19, and physical health status. Results showed that the older the participants, the lower the perceived vulnerability to getting COVID-19, but the higher the perceived severity. Different predictors explain the perception of risk severity and vulnerability at different ages. Overall, self-reported anxiety over the pandemic is a crucial predictor in explaining risk perceptions in all age groups. Theoretical and practical implications of the empirical findings are discussed. [ABSTRACT FROM AUTHOR]

Older adults are assumed to change their affect states in reaction to positive and negative stimuli across the life span. However, little is known about the impact of success and failure events on age-related changes in affect states and, particularly, in self-esteem levels. To fill this gap in the literature, in the present study changes in affect and self-esteem in 100 young (19–30 years) and 102 older adults (65–81 years) were assessed after participants experienced success and failure in a demanding cognitive task. Overall, the success-failure manipulation induced changes on affect states and on state self-esteem, not on trait self-esteem. Regarding age differences, older and young adults were affected to the same extent by experiences of successes and failures. Theoretical considerations of the empirical findings are provided in the general discussion. [ABSTRACT FROM AUTHOR]

Recently, some authors have suggested that age-related impairments in social-cognitive abilities—emotion recognition (ER) and theory of mind (ToM)—may be explained in terms of reduced motivation and effort mobilization in older adults. We examined performance on ER and ToM tasks, as well as corresponding control tasks, experimentally manipulating self-involvement. Sixty-one older adults and 57 young adults were randomly assigned to either a High or Low self-involvement condition. In the first condition, self-involvement was raised by telling participants were told that good task performance was associated with a number of positive, personally relevant social outcomes. Motivation was measured with both subjective (self-report questionnaire) and objective (systolic blood pressure reactivity—SBP-R) indices. Results showed that the self-involvement manipulation did not increase self-reported motivation, SBP-R, or task performance. Further correlation analyses focusing on individual differences in motivation did not reveal any association with performance, in either young or older adults. Notably, we found age-related decline in both ER and ToM, despite older adults having higher motivation than young adults. Overall, the present results were not consistent with previous claims that motivation affects older adults’ social-cognitive performance, opening the route to potential alternative explanations. [ABSTRACT FROM AUTHOR]

Growing evidence indicates that Theory of Mind (ToM) declines in normal aging. However, the majority of this research has used classic and static verbal tasks that present scenarios, which are very different from real life. The present study was designed to fill this gap by administering the Movie for the Assessment of Social Cognition (MASC) to young and older participants. It allows one to analyze not only the accuracy, but also the typology of error in mental states attribution distinguishing between iper-ToM (over-mentalization), ipo-ToM (insufficient mentalization), and no-ToM (lack of mentalization). We recruited 30 young (20-29 years), 39 young-old (65-74 years), and 31 old-old (75-86 years) participants. Along with the MASC, we administered a classic ToM task, the Strange Stories, and several measures of cognitive functioning. Results showed that older adults were less accurate in mental state attribution than young adults in the MASC, but not in the Strange Stories. In addition, compared to young adults, older adults committed more errors of both ipo- and no-ToM, while young adults committed more often iper-ToM errors. Additionally, older adults, but not young adults, did not show a difference between iper-ToM and ipo-ToM errors, which were equally frequent in this age group. Globally, results indicated that older adults' failure in classic ToM tasks may be due to both ipo- and iper-ToM and provide needed evidence for the MASC as a suitable measure of ToM in aging. [ABSTRACT FROM AUTHOR]

Older adults perform worse than younger adults when applying decision rules to choose between options that vary along multiple attributes. Although previous studies have shown that general fluid cognitive abilities contribute to the accurate application of decision rules, relatively little is known about which specific cognitive abilities play the most important role. We examined the independent roles of working memory, verbal fluency, semantic knowledge, and components of executive functioning. We found that age-related decline in applying decision rules was statistically mediated by age-related decline in working memory and verbal fluency. Our results have implications for theories of aging and decision-making. [ABSTRACT FROM AUTHOR]

We determined the applicability of deriving the stature from knee height in an older Italian population, and, in the same population, we assessed longitudinally the change in stature over a 6-year interval. The standing stature and knee height in a supine position were measured in the entire home-dwelling older (65 + years) population of a small Italian town (N = 606). Stature measured in 1989 and in 1995 was used to assess longitudinal changes in 258 subjects of the same population. Stature derived from knee height was greater than measured stature in this population and in the two sexes. This difference disappeared when subjects with evident kyphosis were excluded. From 1989 to 1995, stature decreased by 1.7+/-3.0 cm, with women showing a larger decrement than men. Stature estimated from knee height is more accurate than measured stature in subjects with kyphosis. In accordance with previous studies, stature decreases with aging, and such height loss is greater in women than in men. [ABSTRACT FROM AUTHOR]

In nonpathological elders, cognitive decline is more evident by middle age and depends on different factors, such as speed of processing, nature of the task (i.e., storing versus processing), and type of stimuli (i.e., verbal versus visual and spatial) to be recalled. The present study aimed to investigate the impact of age and environmental factors (i.e., retirement home versus one's own home) on visuo-spatial working memory functions of healthy elderly (73 to 81 years old) and very old participants (83 to 90 years old). Results showed that visuo-spatial working memory processes in the institutionalized sample were comparable with those in free-living participants. A differential age effect was more evident for mnestic tasks involving the manipulation of stimuli. [ABSTRACT FROM AUTHOR]

: ObjectivesWe investigated cardiac and vascular remodeling in an unselected older population with either diastolic hypertension (HTN) or isolated systolic hypertension (ISH).: BackgroundIsolated systolic hypertension accounts for a substantial proportion of hypertension in individuals older than 65 years and is strongly associated with an increased risk of cardiac and cerebrovascular events. The exact mechanisms underlying the increased risk associated with ISH and elevated pulse pressure (PP), in comparison with HTN, have not been extensively investigated.: MethodsCommunity-dwelling residents age ≥65 years in a small town in Italy (Dicomano) were enrolled. Untreated subjects considered in this study included 173 normotensive subjects (blood pressure [BP] <140/90 mm Hg), 95 subjects with HTN (diastolic BP ≥90 mm Hg), and 43 subjects with ISH (BP ≥160/<90 mm Hg). All subjects underwent extensive clinical examination, echocardiography, carotid ultrasonography, and carotid applanation tonometry.: ResultsSubjects with ISH had higher left ventricular (LV) mass, which was independently related to PP but not to systolic or mean pressures. Both carotid wall cross-sectional area and vascular stiffness were greater in ISH patients than in HTN and normal subjects and were independently related to PP but not to systolic BP. In addition, ISH was associated with a higher prevalence of carotid plaque and more extensive carotid atherosclerosis.: ConclusionsIn our community-based elderly population, individuals with ISH had higher prevalences of LV hypertrophy and carotid atherosclerosis than subjects with HTN despite lower mean BP. These findings provide potential pathophysiologic mechanisms underlying the associations of ISH and PP with increased risk of cardiovascular morbidity and mortality. [Copyright &y& Elsevier]

Past literature on prosocial behavior in aging has mainly focused on age-related differences. However, the analysis of the predictors of prosociality in late adulthood is still under investigated. The present study examines how personality traits predict actual and self-reported prosocial behaviors, while considering the mediation effects of empathic concern and the moderator effect of age, in an Italian sample of 150 participants aged from 55 to 86 years old (M age = 69.52). Based on a path analysis model, results revealed that agreeableness has a direct association with self-reported prosocial behavior and an indirect relationship, via empathic concern, with actual prosocial behavior. In addition, emotional stability further explains variations in older adults' prosociality, via empathic concern. Age also plays a different role on actual and self-reported behaviors. While the relationship between empathic concern and actual behavior is the same in middle-aged and older adults, in the self-reported behaviors it changes according to the age of participants. As they grow older, people perform prosocial acts in daily life driven by basic dispositions, such as agreeableness, and not by empathic concern. These findings have important implications regarding the understanding of the motives that drive the different prosocial behaviors in the older population. [ABSTRACT FROM AUTHOR]

• NT-proBNP is a sensible and specific marker of heart failure, and its plasma levels also increase with age. The mortality predictive value of NT-proBNP in patients without heart failure, especially older adults, is less established. • In the present study of patients with type 2 diabetes mellitus stabilised after an ACS, elevated NT-proBNP levels are the most powerful predictor of all-cause and cardiovascular mortality across age categories, and its predictive information does not tend to decrease with age. • This information should inform treatment strategies and future practice Guidelines. To assess the impact of age on the prognostic value of NT-proBNP concentration in patients with type-2 diabetes mellitus (T2DM) stabilised after an Acute Coronary Syndrome (ACS). The AleCardio study compared aleglitazar with placebo in 7226 patients with T2DM and recent ACS. Patients with heart failure were excluded. Median follow-up was 104 weeks. Baseline NT-proBNP plasma concentration was measured centrally. Multivariable Cox regression was used to determine the mortality predictive information provided by NT-proBNP across age groups. Median age was 61y (IQR 54, 67). NT-proBNP concentration increased by quartile (Q) of age (median 264, 318, 391, and 588 pg/ml). Compared to Q1, patients in Q4 of NT-proBNP had higher (p < 0.001) adjusted HR for all-cause (aHR 6.9; 95 % CI 4.0–12) and cardiovascular (11; 5.4–23) death. Within each age Q, baseline NT-proBNP in patients who died was 3 times higher than in survivors (all p < 0.001). When age and NT-proBNP levels were modeled as continuous variables, their interaction term was nonsignificant. The relative prognostic information provided by NT-proBNP (percent of total X2) increased from 38 % in age Q1 to 75 % in age Q4 for mortality, and from 50 % to 88 % for CV death. Among patients with T2DM stabilised after an ACS, NT-proBNP level predicts death irrespective of age. [ABSTRACT FROM AUTHOR]

• We investigated the unexplored domain of pragmatic intervention in healthy aging. • We used a novel training program (PragmaCom) compared with a cognitive training. • Both PragmaCom and cognitive training produced improvement in pragmatics. • Individual factors played a greater role in the cognitive than in PragmaCom group. • Results point to pragmatic plasticity. Among all aspects of the linguistic and communicative competence, pragmatics seems especially vulnerable in aging, due also to cognitive decline. However, pragmatics has never been considered as an intervention target in healthy aging. Here we tested the effects of a novel training program to improve pragmatics (PragmaCom) in older adults, compared with an active cognitive control group in a randomized-controlled-trial design. Both the PragmaCom group and the control group improved in pragmatic skills such as understanding metaphors and avoiding off-topic speech, indicating that it is possible to improve pragmatics in aging both with a specific training and with a cognitive training. Individual cognitive factors predicted pragmatic improvement in the control group, while in the PragmaCom group benefits were less dependent on individual characteristics. We discuss the results in terms of pragmatic plasticity, highlighting the importance of these findings for promoting older adults' social communication and well-being. [ABSTRACT FROM AUTHOR]